Plan Benefit Materials |

Plan Materials and Forms

 

Information about plan benefits, services, and drug costs can be found in your plan materials.

Look at your Wellcare By Allwell from Magnolia Health member ID card for your plan number and type to view materials for your plan. 

  • View a sample of an Wellcare By Allwell Member ID Card to see where this information is located.

You can also look for plan materials based on the plan name and the county you live in.

If you don’t have a Wellcare By Allwell from Magnolia Health ID card or have questions about plan materials, give us a call. We’re here to help.

This booklet gives you a summary of costs and coverage in your plan. 

Please select the document for your plan and county:For HMO Members:

Plan Name  CMS# County Summary of Benefits
Wellcare No Premium Medicare (HMO)
H9811-001 George, Hancock, Harrison, Hinds, Jackson, Madison, Rankin and Stone counties
Wellcare Giveback Boost (HMO) H9811-008 George, Hancock, Harrison, Jackson
Wellcare Assist Complement (HMO) H9811-009 George, Hancock, Harrison, Jackson


For HMO D-SNP Members:

Plan Name  CMS# County Summary of Benefits
Wellcare Dual Access Medicare (HMO D-SNP) H9811-006 George, Hancock, Harrison, Hinds, Jackson, Madison, Rankin and Stone

This booklet gives you a complete list of services, limitations and exclusions for your plan coverage.

Please select the document for your plan and county:

For HMO Members:

Plan Name CMS# County Evidence of Coverage 

Wellcare No Premium Medicare (HMO)

 

H9811-001

 

 

Desoto, George, Hancock, Harrison, Hinds, Jackson, Lafayette, Madison, Panola, Rankin, Stone, Tate

Wellcare Giveback Boost (HMO) H9811-008 George, Hancock, Harrison, Jackson
Wellcare Assist Complement (HMO) H9811-009 George, Hancock, Harrison, Jackson


For HMO D-SNP Members:

Plan Name  CMS# County Evidence of Coverage
Wellcare Dual Access Medicare (HMO D-SNP) H9811-006 George, Hancock, Harrison, Hinds, Jackson, Madison, Rankin and Stone

This booklet will tell you about changes to your plan’s costs and benefits for the coming year.

Please select the document for your plan and county:

For HMO Members:

Plan Name  CMS# County Annual Notice Of Changes
Wellcare No Premium Medicare (HMO) H9811-001 George, Harrison, Hinds, Jackson, Madison, Rankin and Stone counties
Allwell Medicare (HMO) to Wellcare No Premium Medicare (HMO) H9811-005 - H9811-001 DeSoto, Lafayette, Panola, and Tate counties
Wellcare Giveback Boost (HMO) H9811-008 George, Hancock, Harrison, Jackson
Wellcare Assist Complement (HMO) H9811-009 George, Hancock, Harrison, Jackson

For HMO-D-SNP Members:

Plan Name  CMS# County Annual Notice Of Changes
Wellcare Dual Access Medicare (HMO D-SNP) H9811-006 George, Hancock, Harrison, Hinds, Jackson, Madison, Rankin and Stone